Background: Inadequate and excessive gestational weight gain (GWG) is among the most important determinant of adverse pregnancy and birth outcomes. In most developing countries including Malawi, monitoring changes in pregnancy weight is challenging because of late Antenatal care (ANC) attendance. In addition, it is not a routine procedure to monitor and recommend appropriate gestational weight gain in Malawi. Objectives: To identify factors associated with the rate of gestational weight gain and with other indicators of nutritional status in a rural setting of Malawi, and to compare if the weekly weight gain is in accordance to the Institute Of Medicine recommendations for pregnant women in different BMI categories of nutritional status. Methodology: A longitudinal study was done on 257 pregnant women who were recruited in the first and second trimester of their pregnancies to participate in a cluster randomized controlled intervention study. Measurements of maternal weight were done at recruitment and at pregnancy midpoint check-up at local health clinics. Changes in weekly gestational weight over this period were compared to 2009 guidelines set by the IOM to determine whether the pregnant women were meeting these guidelines. Haemoglobin (Hb), Mid Upper Arm Circumference (MUAC) and skinfold thickness measurements were taken at the time of recruitment. Analysis: Binary data (met IOM guidelines/ not met) were analyzed using the logistic regression model within the generalized linear regression model (GLM) framework to determine factors that were associated with the rate of gestational weight gain. Prevalence of inadequate gestational weight gain was also determined. The GLM was also used to identify factors associated with haemoglobin (Hb) status, MUAC and body fat percentage at recruitment. Results: The study revealed that 19.8% of the pregnant mothers gained adequate GWG. The mean GWG per week was 0.26 (SD ± 0.2) kg. Starting pregnancy before harvest season was significantly associated with inadequate GWG, (AOR = 0.33, 95 % CI 0.16, 0.65) significantly predicted GWG. The factors that were associated with low Hb status on recruitment were malaria β and higher gestational age on recruitment. Maternal age was significantly associated with large MUAC whereas very poor socio economic status (SES) and large households significantly decreased the size of MUAC. Each one year increase in age was associated with an increase in body fat percentage whereas lower body fat was common among women from very poor SES. Conclusion: A small proportion of the pregnant women obtained adequate gestational weight gain. Season of recruitment significantly predicted GWG; before harvest season was associated with a lower weight gain.